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This Article Full Text Full Text (PDF) All Versions of this Article: 295/3/H1109    most recent 00395.2008v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Web of Science (1) Citing Articles via Google Scholar Google Scholar Articles by Baggish, A. L. Articles by Wood, M. J. Search for Related Content PubMed PubMed Citation Articles by Baggish, A. L. Articles by Wood, M. J.

The impact of endurance exercise training on left ventricular systolic mechanics

¹Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts; and ²University Health Services, Harvard University, Cambridge, Massachusetts

Submitted 15 April 2008 ; accepted in final form 7 July 2008

Although exercise training-induced changes in left ventricular (LV) structure are well characterized, adaptive functional changes are incompletely understood. Detailed echocardiographic assessment of LV systolic function was performed on 20 competitive rowers (10 males and 10 females) before and after endurance exercise training (EET; 90 days, 10.7 ± 1.1 h/wk). Structural changes included LV dilation (end-diastolic volume = 128 ± 25 vs. 144 ± 28 ml, P < 0.001), right ventricular (RV) dilation (end-diastolic area = 2,850 ± 550 vs. 3,260 ± 530 mm², P < 0.001), and LV hypertrophy (mass = 227 ± 51 vs. 256 ± 56 g, P < 0.001). Although LV ejection fraction was unchanged (62 ± 3% vs. 60 ± 3%, P = not significant), all direct measures of LV systolic function were altered. Peak systolic tissue velocities increased significantly (basal lateral S' = 0.9 ± 0.6 cm/s, P = 0.004; and basal septal S' = 0.8 ± 0.4 cm/s, P = 0.008). Radial strain increased similarly in all segments, whereas longitudinal strain increased with a base-to-apex gradient. In contrast, circumferential strain (CS) increased in the LV free wall but decreased in regions adjacent to the RV. Reductions in septal CS correlated strongly with changes in RV structure (RV end-diastolic area vs. LV septal CS; r² = 0.898, P < 0.001) and function (peak RV systolic velocity vs. LV septal CS, r² = 0.697, P < 0.001). EET leads to significant changes in LV systolic function with regional heterogeneity that may be secondary to concomitant RV adaptation. These changes are not detected by conventional measurements such as ejection fraction.

athlete's heart; left ventricle; strain; ventricular interdependence